![]() ![]() 22, 28īased on randomized controlled trials and observational studies with disease-oriented outcomes. Preventive Services Task Force and the American Academy of Family Physicians conclude that the current evidence is insufficient to assess the balance of benefits and harms of screening for hearing loss in asymptomatic adults 50 years and older. Cochlear implants can be helpful for those with refractory or severe hearing loss. Patients with conductive hearing loss or sensorineural loss that does not improve with hearing aids should be referred to an otolaryngologist. Patients with sensorineural hearing loss should be referred to an audiologist for consideration of hearing aids. ![]() Other aspects of treatment include auditory rehabilitation, education, and eliminating or reducing use of ototoxic medications. Treating cerumen impaction with irrigation or curettage is potentially curative. Computed tomography or magnetic resonance imaging is indicated in patients with asymmetrical hearing loss or sudden sensorineural hearing loss, and when ossicular chain damage is suspected. Laboratory evaluation is not indicated unless systemic illness is suspected. Sudden sensorineural hearing loss (loss of 30 dB or more within 72 hours) requires prompt otolaryngology referral. Patients should then undergo examination for cerumen impaction, exostoses, and other abnormalities of the external canal and tympanic membrane, in addition to a neurologic examination. Patients with suspected hearing loss should undergo in-office hearing tests such as the whispered voice test or audiometry. ![]() Patients may present with self-recognized hearing loss, or family members may observe behaviors (e.g., difficulty understanding conversations, increasing television volume) that suggest hearing loss. Several approaches can be used to screen for hearing loss, but the benefits of screening are uncertain. Age-related sensorineural hearing loss (i.e., presbycusis) is the most common type in adults. Hearing loss is categorized as conductive, sensorineural, or mixed. This condition is underrecognized, and hearing aids and other hearing enhancement technologies are underused. ![]()
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